What is the Most Severe Form of Depression Called?

Clinical depression is the most extreme form of depression also known as major depressive disorder. Learn about its symptoms & treatment options.

What is the Most Severe Form of Depression Called?

Clinical depression is the most extreme manifestation of depression, also known as major depression or major depressive disorder. It is not the same as depression caused by a loss, such as the death of a loved one, or a medical condition, such as a thyroid disorder. Your doctor may call it major depressive disorder. You can have this type of illness if you feel depressed most of the time on most days of the week.

Persistent depressive disorder, also called dysthymia (Dis-thie-me-uh), is an ongoing form of long-term (chronic) depression. You may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and a general sense of inadequacy. These feelings last for years and can significantly interfere with your relationships, school, work, and daily activities. Not only is depression difficult to endure, it is also a risk factor for heart disease and dementia.

Depressive symptoms can occur in adults for many reasons. If you experience cognitive or mood changes that last more than a few weeks, it's a good idea to contact your doctor or see a mental health specialist to help determine possible causes, says Dr. Nancy Donovan, Psychiatry Instructor at Harvard Medical School. The classic type of depression, major depression, is a state in which a dark mood consumes everything and you lose interest in activities, even those that are usually pleasurable.

Symptoms of this type of depression include difficulty sleeping, changes in appetite or weight, loss of energy, and feeling worthless. Thoughts of death or suicide may occur. It is usually treated with psychotherapy and medication. For some people with severe depression that is not relieved by psychotherapy or antidepressant medications, electroconvulsive therapy may be effective.

Formerly called dysthymia, this type of depression refers to low mood that has lasted at least two years but may not reach the intensity of major depression. Many people with this type of depression can function day by day, but they feel depressed or joyless most of the time. Other depressive symptoms may include changes in appetite and sleep, lack of energy, low self-esteem or hopelessness. Depression (major depressive disorder or clinical depression) is a common but serious mood disorder that causes severe symptoms that affect how you feel, think, and manage daily activities, such as sleeping, eating, or working. To be diagnosed with depression, symptoms must be present for at least two weeks.

Although the exact causes of major depression are unknown, some risk factors include a family history of depression and major life events, such as trauma, moments of high stress, loss of a job or relationship, or the death of a loved one. This booklet provides information about depression, including the different types of depression, signs and symptoms, how it is diagnosed, treatment options, and how to find help for yourself or a loved one. Other more recently introduced types of brain stimulation therapies used to treat drug-resistant depression include repetitive transcranial magnetic stimulation (RTMS) and vagus nerve stimulation (VNS). While most people feel sad at some points in their lives, major depression occurs when a person is depressed most of the day, almost every day, for at least two weeks. Examples of other types of depressive disorders that have recently been added to the DSM-5 diagnostic classification include mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD). Several types of psychotherapy (also called “psychotherapy” or counseling) can help people with depression. Although persistent depressive disorder is not as severe as major depression, your current depressed mood may be mild, moderate, or severe.

Women who have major depression in the weeks and months after childbirth may have peripartum depression. This is the term used to describe a severe form of depression in which many of the physical symptoms of depression are present. Traditional antidepressants are not always recommended as first-line treatments for bipolar depression because there is no evidence that these drugs are more useful than a placebo (a sugar pill) for treating depression in people with bipolar disorder. Bipolar disorder used to be known as “manic depression” because the person experiences periods of depression and periods of mania with periods of normal mood between them. Sometimes they may also recommend an older type of antidepressant called MAOIs (monoamine oxidase inhibitor), which is a class of antidepressants that has been well studied to treat atypical depression. Some people also have episodes of major depression before or while they have persistent depressive disorder.

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